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Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

Case Study SWOT Analysis Solution

Case Study Description of Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary


High performance is often attributed to an organization's culture. However, culture can just as easily undermine performance when it blinds decision makers to important performance issues and entraps them in unfortunate courses of action from which they cannot disengage. The dynamics of cultural entrapment are explored in the case of the Bristol Royal Infirmary, in which pediatric cardiac surgeries continued for over a 14-year period despite evidence of poor-quality care and performance that was far below that of other comparable pediatric surgical centers. A single organizational process of behavioral commitment explains how the cultural mindset originated and why it persisted. The sequence of small, public, volitional, and irrevocable action; socially acceptable justification for that action; and the potential for subsequent activities to validate or threaten the justification created a causal loop that stabilized subsequent action patterns.

Authors :: Karl E. Weick, Kathleen M. Sutcliffe

Topics :: Organizational Development

Tags :: Organizational culture, Performance measurement, SWOT Analysis, SWOT Matrix, TOWS, Weighted SWOT Analysis

Swot Analysis of "Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary" written by Karl E. Weick, Kathleen M. Sutcliffe includes – strengths weakness that are internal strategic factors of the organization, and opportunities and threats that Entrapment Infirmary facing as an external strategic factors. Some of the topics covered in Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary case study are - Strategic Management Strategies, Organizational culture, Performance measurement and Organizational Development.


Some of the macro environment factors that can be used to understand the Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary casestudy better are - – there is increasing trade war between United States & China, increasing commodity prices, geopolitical disruptions, increasing inequality as vast percentage of new income is going to the top 1%, cloud computing is disrupting traditional business models, increasing government debt because of Covid-19 spendings, supply chains are disrupted by pandemic , central banks are concerned over increasing inflation, banking and financial system is disrupted by Bitcoin and other crypto currencies, etc



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Introduction to SWOT Analysis of Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary


SWOT stands for an organization’s Strengths, Weaknesses, Opportunities and Threats . At Oak Spring University , we believe that protagonist in Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary case study can use SWOT analysis as a strategic management tool to assess the current internal strengths and weaknesses of the Entrapment Infirmary, and to figure out the opportunities and threats in the macro environment – technological, environmental, political, economic, social, demographic, etc in which Entrapment Infirmary operates in.

According to Harvard Business Review, 75% of the managers use SWOT analysis for various purposes such as – evaluating current scenario, strategic planning, new venture feasibility, personal growth goals, new market entry, Go To market strategies, portfolio management and strategic trade-off assessment, organizational restructuring, etc.




SWOT Objectives / Importance of SWOT Analysis and SWOT Matrix


SWOT analysis of Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary can be done for the following purposes –
1. Strategic planning using facts provided in Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary case study
2. Improving business portfolio management of Entrapment Infirmary
3. Assessing feasibility of the new initiative in Organizational Development field.
4. Making a Organizational Development topic specific business decision
5. Set goals for the organization
6. Organizational restructuring of Entrapment Infirmary




Strengths Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary | Internal Strategic Factors
What are Strengths in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

The strengths of Entrapment Infirmary in Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary Harvard Business Review case study are -

Digital Transformation in Organizational Development segment

- digital transformation varies from industry to industry. For Entrapment Infirmary digital transformation journey comprises differing goals based on market maturity, customer technology acceptance, and organizational culture. Entrapment Infirmary has successfully integrated the four key components of digital transformation – digital integration in processes, digital integration in marketing and customer relationship management, digital integration into the value chain, and using technology to explore new products and market opportunities.

Highly skilled collaborators

– Entrapment Infirmary has highly efficient outsourcing and offshoring strategy. It has resulted in greater operational flexibility and bringing down the costs in highly price sensitive segment. Secondly the value chain collaborators of the firm in Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary HBR case study have helped the firm to develop new products and bring them quickly to the marketplace.

Diverse revenue streams

– Entrapment Infirmary is present in almost all the verticals within the industry. This has provided firm in Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary case study a diverse revenue stream that has helped it to survive disruptions such as global pandemic in Covid-19, financial disruption of 2008, and supply chain disruption of 2021.

Low bargaining power of suppliers

– Suppliers of Entrapment Infirmary in the sector have low bargaining power. Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary has further diversified its suppliers portfolio by building a robust supply chain across various countries. This helps Entrapment Infirmary to manage not only supply disruptions but also source products at highly competitive prices.

Training and development

– Entrapment Infirmary has one of the best training and development program in the industry. The effectiveness of the training programs can be measured in Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary Harvard Business Review case study by analyzing – employees retention, in-house promotion, loyalty, new venture initiation, lack of conflict, and high level of both employees and customer engagement.

Successful track record of launching new products

– Entrapment Infirmary has launched numerous new products in last few years, keeping in mind evolving customer preferences and competitive pressures. Entrapment Infirmary has effective processes in place that helps in exploring new product needs, doing quick pilot testing, and then launching the products quickly using its extensive distribution network.

Learning organization

- Entrapment Infirmary is a learning organization. It has inculcated three key characters of learning organization in its processes and operations – exploration, creativity, and expansiveness. The work place at Entrapment Infirmary is open place that encourages instructiveness, ideation, open minded discussions, and creativity. Employees and leaders in Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary Harvard Business Review case study emphasize – knowledge, initiative, and innovation.

Ability to lead change in Organizational Development field

– Entrapment Infirmary is one of the leading players in its industry. Over the years it has not only transformed the business landscape in its segment but also across the whole industry. The ability to lead change has enabled Entrapment Infirmary in – penetrating new markets, reaching out to new customers, and providing different value propositions to different customers in the international markets.

Operational resilience

– The operational resilience strategy in the Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary Harvard Business Review case study comprises – understanding the underlying the factors in the industry, building diversified operations across different geographies so that disruption in one part of the world doesn’t impact the overall performance of the firm, and integrating the various business operations and processes through its digital transformation drive.

Superior customer experience

– The customer experience strategy of Entrapment Infirmary in the segment is based on four key concepts – personalization, simplification of complex needs, prompt response, and continuous engagement.

Organizational Resilience of Entrapment Infirmary

– The covid-19 pandemic has put organizational resilience at the centre of everthing that Entrapment Infirmary does. Organizational resilience comprises - Financial Resilience, Operational Resilience, Technological Resilience, Organizational Resilience, Business Model Resilience, and Reputation Resilience.

Ability to recruit top talent

– Entrapment Infirmary is one of the leading recruiters in the industry. Managers in the Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary are in a position to attract the best talent available. The firm has a robust talent identification program that helps in identifying the brightest.






Weaknesses Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary | Internal Strategic Factors
What are Weaknesses in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

The weaknesses of Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary are -

Ability to respond to the competition

– As the decision making is very deliberative, highlighted in the case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary, in the dynamic environment Entrapment Infirmary has struggled to respond to the nimble upstart competition. Entrapment Infirmary has reasonably good record with similar level competitors but it has struggled with new entrants taking away niches of its business.

High cash cycle compare to competitors

Entrapment Infirmary has a high cash cycle compare to other players in the industry. It needs to shorten the cash cycle by 12% to be more competitive in the marketplace, reduce inventory costs, and be more profitable.

Capital Spending Reduction

– Even during the low interest decade, Entrapment Infirmary has not been able to do capital spending to the tune of the competition. This has resulted into fewer innovations and company facing stiff competition from both existing competitors and new entrants who are disrupting the industry using digital technology.

Products dominated business model

– Even though Entrapment Infirmary has some of the most successful products in the industry, this business model has made each new product launch extremely critical for continuous financial growth of the organization. firm in the HBR case study - Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary should strive to include more intangible value offerings along with its core products and services.

Workers concerns about automation

– As automation is fast increasing in the segment, Entrapment Infirmary needs to come up with a strategy to reduce the workers concern regarding automation. Without a clear strategy, it could lead to disruption and uncertainty within the organization.

No frontier risks strategy

– After analyzing the HBR case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary, it seems that company is thinking about the frontier risks that can impact Organizational Development strategy. But it has very little resources allocation to manage the risks emerging from events such as natural disasters, climate change, melting of permafrost, tacking the rise of artificial intelligence, opportunities and threats emerging from commercialization of space etc.

High bargaining power of channel partners

– Because of the regulatory requirements, Karl E. Weick, Kathleen M. Sutcliffe suggests that, Entrapment Infirmary is facing high bargaining power of the channel partners. So far it has not able to streamline the operations to reduce the bargaining power of the value chain partners in the industry.

Low market penetration in new markets

– Outside its home market of Entrapment Infirmary, firm in the HBR case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary needs to spend more promotional, marketing, and advertising efforts to penetrate international markets.

Employees’ incomplete understanding of strategy

– From the instances in the HBR case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary, it seems that the employees of Entrapment Infirmary don’t have comprehensive understanding of the firm’s strategy. This is reflected in number of promotional campaigns over the last few years that had mixed messaging and competing priorities. Some of the strategic activities and services promoted in the promotional campaigns were not consistent with the organization’s strategy.

High dependence on star products

– The top 2 products and services of the firm as mentioned in the Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary HBR case study still accounts for major business revenue. This dependence on star products in has resulted into insufficient focus on developing new products, even though Entrapment Infirmary has relatively successful track record of launching new products.

Skills based hiring

– The stress on hiring functional specialists at Entrapment Infirmary has created an environment where the organization is dominated by functional specialists rather than management generalist. This has resulted into product oriented approach rather than marketing oriented approach or consumers oriented approach.




Opportunities Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary | External Strategic Factors
What are Opportunities in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis


The opportunities highlighted in the Harvard Business Review case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary are -

Reconfiguring business model

– The expansion of digital payment system, the bringing down of international transactions costs using Bitcoin and other blockchain based currencies, etc can help Entrapment Infirmary to reconfigure its entire business model. For example it can used blockchain based technologies to reduce piracy of its products in the big markets such as China. Secondly it can use the popularity of e-commerce in various developing markets to build a Direct to Customer business model rather than the current Channel Heavy distribution network.

Harnessing reconfiguration of the global supply chains

– As the trade war between US and China heats up in the coming years, Entrapment Infirmary can build a diversified supply chain model across various countries in - South East Asia, India, and other parts of the world. This reconfiguration of global supply chain can help, as suggested in case study, Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary, to buy more products closer to the markets, and it can leverage its size and influence to get better deal from the local markets.

Low interest rates

– Even though inflation is raising its head in most developed economies, Entrapment Infirmary can still utilize the low interest rates to borrow money for capital investment. Secondly it can also use the increase of government spending in infrastructure projects to get new business.

Reforming the budgeting process

- By establishing new metrics that will be used to evaluate both existing and potential projects Entrapment Infirmary can not only reduce the costs of the project but also help it in integrating the projects with other processes within the organization.

Learning at scale

– Online learning technologies has now opened space for Entrapment Infirmary to conduct training and development for its employees across the world. This will result in not only reducing the cost of training but also help employees in different part of the world to integrate with the headquarter work culture, ethos, and standards.

Manufacturing automation

– Entrapment Infirmary can use the latest technology developments to improve its manufacturing and designing process in Organizational Development segment. It can use CAD and 3D printing to build a quick prototype and pilot testing products. It can leverage automation using machine learning and artificial intelligence to do faster production at lowers costs, and it can leverage the growth in satellite and tracking technologies to improve inventory management, transportation, and shipping.

Use of Bitcoin and other crypto currencies for transactions

– The popularity of Bitcoin and other crypto currencies as asset class and medium of transaction has opened new opportunities for Entrapment Infirmary in the consumer business. Now Entrapment Infirmary can target international markets with far fewer capital restrictions requirements than the existing system.

Using analytics as competitive advantage

– Entrapment Infirmary has spent a significant amount of money and effort to integrate analytics and machine learning into its operations in the sector. This continuous investment in analytics has enabled, as illustrated in the Harvard case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary - to build a competitive advantage using analytics. The analytics driven competitive advantage can help Entrapment Infirmary to build faster Go To Market strategies, better consumer insights, developing relevant product features, and building a highly efficient supply chain.

Buying journey improvements

– Entrapment Infirmary can improve the customer journey of consumers in the industry by using analytics and artificial intelligence. Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary suggest that firm can provide automated chats to help consumers solve their own problems, provide online suggestions to get maximum out of the products and services, and help consumers to build a community where they can interact with each other to develop new features and uses.

Building a culture of innovation

– managers at Entrapment Infirmary can make experimentation a productive activity and build a culture of innovation using approaches such as – mining transaction data, A/B testing of websites and selling platforms, engaging potential customers over various needs, and building on small ideas in the Organizational Development segment.

Loyalty marketing

– Entrapment Infirmary has focused on building a highly responsive customer relationship management platform. This platform is built on in-house data and driven by analytics and artificial intelligence. The customer analytics can help the organization to fine tune its loyalty marketing efforts, increase the wallet share of the organization, reduce wastage on mainstream advertising spending, build better pricing strategies using personalization, etc.

Identify volunteer opportunities

– Covid-19 has impacted working population in two ways – it has led to people soul searching about their professional choices, resulting in mass resignation. Secondly it has encouraged people to do things that they are passionate about. This has opened opportunities for businesses to build volunteer oriented socially driven projects. Entrapment Infirmary can explore opportunities that can attract volunteers and are consistent with its mission and vision.

Creating value in data economy

– The success of analytics program of Entrapment Infirmary has opened avenues for new revenue streams for the organization in the industry. This can help Entrapment Infirmary to build a more holistic ecosystem as suggested in the Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary case study. Entrapment Infirmary can build new products and services such as - data insight services, data privacy related products, data based consulting services, etc.




Threats Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary External Strategic Factors
What are Threats in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis


The threats mentioned in the HBR case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary are -

Regulatory challenges

– Entrapment Infirmary needs to prepare for regulatory challenges as consumer protection groups and other pressure groups are vigorously advocating for more regulations on big business - to reduce inequality, to create a level playing field, to product data privacy and consumer privacy, to reduce the influence of big money on democratic institutions, etc. This can lead to significant changes in the Organizational Development industry regulations.

High level of anxiety and lack of motivation

– the Great Resignation in United States is the sign of broader dissatisfaction among the workforce in United States. Entrapment Infirmary needs to understand the core reasons impacting the Organizational Development industry. This will help it in building a better workplace.

Barriers of entry lowering

– As technology is more democratized, the barriers to entry in the industry are lowering. It can presents Entrapment Infirmary with greater competitive threats in the near to medium future. Secondly it will also put downward pressure on pricing throughout the sector.

Backlash against dominant players

– US Congress and other legislative arms of the government are getting tough on big business especially technology companies. The digital arm of Entrapment Infirmary business can come under increasing regulations regarding data privacy, data security, etc.

Trade war between China and United States

– The trade war between two of the biggest economies can hugely impact the opportunities for Entrapment Infirmary in the Organizational Development industry. The Organizational Development industry is already at various protected from local competition in China, with the rise of trade war the protection levels may go up. This presents a clear threat of current business model in Chinese market.

Increasing wage structure of Entrapment Infirmary

– Post Covid-19 there is a sharp increase in the wages especially in the jobs that require interaction with people. The increasing wages can put downward pressure on the margins of Entrapment Infirmary.

High dependence on third party suppliers

– Entrapment Infirmary high dependence on third party suppliers can disrupt its processes and delivery mechanism. For example -the current troubles of car makers because of chip shortage is because the chip companies started producing chips for electronic companies rather than car manufacturers.

Capital market disruption

– During the Covid-19, Dow Jones has touched record high. The valuations of a number of companies are way beyond their existing business model potential. This can lead to capital market correction which can put a number of suppliers, collaborators, value chain partners in great financial difficulty. It will directly impact the business of Entrapment Infirmary.

Increasing international competition and downward pressure on margins

– Apart from technology driven competitive advantage dilution, Entrapment Infirmary can face downward pressure on margins from increasing competition from international players. The international players have stable revenue in their home market and can use those resources to penetrate prominent markets illustrated in HBR case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary .

Instability in the European markets

– European Union markets are facing three big challenges post Covid – expanded balance sheets, Brexit related business disruption, and aggressive Russia looking to distract the existing security mechanism. Entrapment Infirmary will face different problems in different parts of Europe. For example it will face inflationary pressures in UK, France, and Germany, balance sheet expansion and demand challenges in Southern European countries, and geopolitical instability in the Eastern Europe.

New competition

– After the dotcom bust of 2001, financial crisis of 2008-09, the business formation in US economy had declined. But in 2020 alone, there are more than 1.5 million new business applications in United States. This can lead to greater competition for Entrapment Infirmary in the Organizational Development sector and impact the bottomline of the organization.

Learning curve for new practices

– As the technology based on artificial intelligence and machine learning platform is getting complex, as highlighted in case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary, Entrapment Infirmary may face longer learning curve for training and development of existing employees. This can open space for more nimble competitors in the field of Organizational Development .

Stagnating economy with rate increase

– Entrapment Infirmary can face lack of demand in the market place because of Fed actions to reduce inflation. This can lead to sluggish growth in the economy, lower demands, lower investments, higher borrowing costs, and consolidation in the field.




Weighted SWOT Analysis of Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary Template, Example


Not all factors mentioned under the Strengths, Weakness, Opportunities, and Threats quadrants in the SWOT Analysis are equal. Managers in the HBR case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary needs to zero down on the relative importance of each factor mentioned in the Strengths, Weakness, Opportunities, and Threats quadrants. We can provide the relative importance to each factor by assigning relative weights. Weighted SWOT analysis process is a three stage process –

First stage for doing weighted SWOT analysis of the case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary is to rank the strengths and weaknesses of the organization. This will help you to assess the most important strengths and weaknesses of the firm and which one of the strengths and weaknesses mentioned in the initial lists are marginal and can be left out.

Second stage for conducting weighted SWOT analysis of the Harvard case study Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary is to give probabilities to the external strategic factors thus better understanding the opportunities and threats arising out of macro environment changes and developments.

Third stage of constructing weighted SWOT analysis of Hospitals as Cultures of Entrapment: A Reanalysis of the Bristol Royal Infirmary is to provide strategic recommendations includes – joining likelihood of external strategic factors such as opportunities and threats to the internal strategic factors – strengths and weaknesses. You should start with external factors as they will provide the direction of the overall industry. Secondly by joining probabilities with internal strategic factors can help the company not only strategic fit but also the most probably strategic trade-off that Entrapment Infirmary needs to make to build a sustainable competitive advantage.



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